Case Study 1: This 19-year-old student was in his usual state of health until the evening prior to admission, when he went to bed with a headache. He told his mother that he felt feverish, and on the following morning his mother found him in bed, moaning and lethargic. He was brought to the emergency room, where he appeared toxic and drowsy, but oriented. His temperature was 40C, his heart rate was 126/min., and his blood pressure was 100/60 mm Hg. He had an impressive purpuric rash (bruise-like), not blanching, most prominent on his trunk, legs and wrists. A gram stain of the material taken from one of the patient’s skin lesions showed gram-negative diplococci. His white blood cell count was 26,000/ml with 25% band forms. The platelet count was 80,000/ml. Blood cultures were obtained and the patient was begun on intravenous ceftriaxone. Blood cultures subsequently grew the organism seen on the gram stains of the lesions. Case Study 1 Question 5:  What virulence factor of this organism is probably responsible for the purpuric rash?

Pathogenic Enterobacteriaceae tend to ferment lactose.

A gram-negative non-fermentative bacillus was isolated from the sputum of a patient with cystic fibrosis. The colonies were green on SBAP and MAC, oxidase positive, and had a characteristic grape-like odor. which of the following is the most likely identity of this organism?

Identify the organism in the list that is not considered a zoonoses:

The organism that has been implicated in peptic ulcer disease is:

Case Study 3: Answer the following questions based upon the following clinical microbiology report: DATE: 10/25/2008  21:22:13                                          bioMerieux Vitek 2 Lab Report PATIENT NAME: HARRIET MORGAN PATIENT ID00000000 SEX: F DOB: 01/01/1931 AGE: 81Y ROUTINE CULTURE  SPECIMEN: URINE  COLONY COUNT= >100,000 CFU/ML ISOLATE: STAPHYLOCOCCUS AUREUS SUSCEPTIBILITY TEST DRUG MIC(mcg/ml) INTERPRETATION ROUTE/DOSAGE AMPICILLIN  >=16 R PO/IV250-500MGQ6H CIPROFLOXACIN >=4 R IM/IV0.5-1.0GMQ8H ERYTHROMYCIN >=8 R PO250-500MGQ6H GENTAMICIN =8 R PO400MGQ12H PENICILLIN G >=16 R IV2.0-3.0GMQ4-6H RIFAMPIN

Mycoplasmas are resistant to penicillins because:

Case Study 1:  The patient was a 37-year-old male with hemophilia.  He was HIV positive and had progressed to full-blown AIDS in the past 3 months.  His current medications included factor VIII treatments, suppressive treatment with the antimicrobial agents trimethoprim/sulfamethoxazole, and azidothymidine (AZT).  He presented with a 3-day history of voluminous bloody diarrhea, 10-lb (ca. 4.5-kg) weight loss, and profound dehydration.  Tests for ova and parasites and culture for Salmonella, Shigella, Yersinia, and Campylobacter were negative three times.  He gave no recent travel history, nor had he recently consumed shellfish. Case Study 1.2:  What role do suppressive antimicrobial agents have in predisposing this patient to his current infection?

Bacillus cereus has been most closely implicated in which of the following diseases?

Neurotoxin is produced by which anaerobic bacteria? Check all which apply.